Patient selective apheresis

Abstract

A system and method for the practice of apheresis employs modules in the system which can be selected for a particular patient to treat particular situations or combinations of difficulties. In one example, Gal-3 mediates a large number of body reactions, and is an effective protector of tumor microenvironments and the like, as well inflammation driver. Removal of Gal-3 may make antic-cancer treatments, like photopheresis and TNF administration more effective. Separate modules, such as one for photopheresis and one for TNF receptor removal, may be combined with a module for the reduction of Gal-3, to render the combination of treatments each more effective than if administered alone.

What is claimed is: 
     
       1. A method for treating a mammal in an ex vivo system, comprising:
 withdrawing an amount of blood from said mammal and introducing it into an ex vivo treatment system, wherein said system comprises at least two modules, wherein each of said modules is intended to modify the composition of said blood extracorporally before returning said withdrawn blood to said patient; 
 wherein at least one of said modules selectively withdraws at least ten percent of galectin-3 in said withdrawn blood by passing said blood through a module provided with a moiety which selectively binds galectin-3 selected from the group consisting of an antibody, antibody fragment, non-antibody peptides, each of which selectively binds galectin-3, a polysaccharide which selectively binds galectin-3, or a combination thereof; 
 wherein at least one of said modules treats said withdrawn blood with photopheresis to expose white blood cells in withdrawn blood to ultraviolet irradiation to render said white blood cells more susceptible to apoptosis upon return to the body and uptake by dendritic cells; and 
 returning said withdrawn blood, comprising said blood with reduced galectin-3 content and ultraviolet irradiated white blood cells to said patient together with remaining blood components, wherein said process of removal of blood, treatment and return is continuous; 
 wherein in one of said modules agents which bind TNF receptors such that said bound receptors are not able to bind with TNF in said mammal are introduced into said withdrawn blood prior to its return to the mammal. 
 
     
     
       2. The method of  claim 1 , wherein said method further comprises removing TNF receptors from said withdrawn blood. 
     
     
       3. The method of  claim 1 , wherein said withdrawn blood is separated into plasma and cellular components prior to introduction of said withdrawn blood into the first of said modules such that treatment in said modules comprises treatment of plasma. 
     
     
       4. An ex vivo system for treatment of blood of a mammal through apheresis, comprising:
 a channel through which blood is withdrawn from said mammal and introduced into said system; 
 at least one module through which said withdrawn blood is directed which comprises a passage for said blood and an agent which selectively binds galectin-3 selected, 
 at least one module for photopheresis of white blood cells present in said blood withdrawn from said mammal so as to expose said white blood cells to ultraviolet irradiation to render said irradiated white blood cells more susceptible to apoptosis and uptake by dendritic cells on return to said mammal, wherein said photopheresis module is upstream or downstream of said galectin-3 binding module, 
 and a channel for return of said withdrawn blood, having been treated to withdraw galectin-3 and irradiate said white blood cells, to said patient, wherein said system provides for withdrawal of said blood, passage of said blood through said modules and return to said patient continuously while the patient is treated; 
 wherein said system comprises a module in which active agents comprising at least moieties which bind TNF receptors in vivo are introduced into said withdrawn blood prior to return of said blood to said mammal. 
 
     
     
       5. The system of  claim 4 , wherein said system further comprises a module wherein TNF receptors and blocking agents are removed from said withdrawn blood, wherein said module is upstream or downstream of said modules for photopheresis and galectin-3 removal, and said withdrawn blood is directed through said module for TNF receptor removal prior to return to said mammal. 
     
     
       6. The system of  claim 4 , wherein said system comprises a filter for the separation of plasma and cellular components of said withdrawn blood, wherein said filter is upstream of all said modules and said withdrawn blood is introduced thereto.